Standardization of criteria in MacCAT-T and MacCAT-CR for monoclonal anti-beta-amyloid antibodies: A Delphi study.

IF 4 Q1 CLINICAL NEUROLOGY

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Pub Date : 2025-05-11 eCollection Date: 2025-04-01 DOI:10.1002/dad2.70112

Jonas Karneboge, Ferdinand von Boehn, Julia Haberstroh

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引用次数: 0

Abstract

Introduction: Assessing capacity to consent to treatment and participation in clinical research with monoclonal anti-beta-amyloid antibodies is critical, especially given the frequent uncertainty in the eligible population. Capacity tends to be underestimated in Alzheimer's patients and overestimated in those with mild cognitive impairment (MCI).

Methods: Using the Delphi method, an international expert panel (N = 21) was surveyed in two waves.

Results: The participants reached consensus on 85 % of identified features, 90 % of benefits, and 88 % of risks.

Discussion: The resulting standard emphasizes the understanding subscale of the MacArthur competence assessment tools (MacCAT) for both treatment and research, supporting use across clinical and research settings. Despite proven utility, only 4 % of psychiatrists currently use tools like MacArthur Competence Assessment Tool for Treatment (MacCAT-T). This consensus aims to promote wider adoption of capacity assessments, integrating them routinely into clinical practice to balance patient autonomy with beneficence.

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MacCAT-T和MacCAT-CR单克隆抗-淀粉样蛋白抗体标准标准化：德尔菲研究

评估单克隆抗-淀粉样蛋白抗体治疗和参与临床研究的能力是至关重要的，特别是考虑到在符合条件的人群中经常存在不确定性。阿尔茨海默病患者的能力往往被低估，而轻度认知障碍（MCI）患者的能力往往被高估。方法：采用德尔菲法，分两批对国际专家小组（N = 21）进行调查。结果：参与者对85%的识别特征、90%的益处和88%的风险达成了共识。讨论：由此产生的标准强调了对治疗和研究中麦克阿瑟能力评估工具（MacCAT）的理解子量表，支持在临床和研究环境中使用。尽管证明了效用，但目前只有4%的精神病医生使用麦克阿瑟治疗能力评估工具（MacCAT-T）这样的工具。这一共识旨在促进更广泛地采用能力评估，将其常规纳入临床实践，以平衡患者自主与有益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring Medicine-Psychiatry and Mental Health

CiteScore

7.80

自引率

7.50%

发文量

101

审稿时长

8 weeks

期刊介绍： Alzheimer''s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM) is an open access, peer-reviewed, journal from the Alzheimer''s Association® that will publish new research that reports the discovery, development and validation of instruments, technologies, algorithms, and innovative processes. Papers will cover a range of topics interested in the early and accurate detection of individuals with memory complaints and/or among asymptomatic individuals at elevated risk for various forms of memory disorders. The expectation for published papers will be to translate fundamental knowledge about the neurobiology of the disease into practical reports that describe both the conceptual and methodological aspects of the submitted scientific inquiry. Published topics will explore the development of biomarkers, surrogate markers, and conceptual/methodological challenges. Publication priority will be given to papers that 1) describe putative surrogate markers that accurately track disease progression, 2) biomarkers that fulfill international regulatory requirements, 3) reports from large, well-characterized population-based cohorts that comprise the heterogeneity and diversity of asymptomatic individuals and 4) algorithmic development that considers multi-marker arrays (e.g., integrated-omics, genetics, biofluids, imaging, etc.) and advanced computational analytics and technologies.